•  

Our medicine team investigate respiratory disease utilising the combined techniques of ultrasound, computed tomography (CT), MRI, endoscopy and fluoroscopy.

We have a range of flexible and rigid endoscopes that give us the ability to look into the nasal chambers, nasopharynx and bronchi of cats and dogs of all sizes. These are often used to support our surgery team in investigation of dogs with obstructive airway disease that may have abnormal airway anatomy that may improve with surgical intervention.

Fluoroscopy enables dynamic interrogation of the respiratory tract for cases of suspected upper and lower airway collapse. Endoscopy and fluoroscopy also allow therapeutic procedures to be carried out, such as foreign body removal and tracheal stent placement.

Our in-house laboratory includes a cytospin centrifuge, facilitating excellent preservation of cells in labile samples such as bronchoalveolar lavage fluid. We also offer in-house measurement of arterial blood gases and lactate concentrations.

Our multidisciplinary hospital also enables investigations to be carried out in conjunction with our other services. For example, cases with pyothorax and lung lobe tumours may be investigated and treated in conjunction with our soft tissue surgery and/or oncology services. Patients with exercise intolerance or episodes of collapse are also commonly referred to AMVS and investigated in conjunction with our soft tissue surgery, orthopaedic, neurology and cardiology services. We can offer dynamic exercise testing in these patients with telemetric ECG, 24-hour digital Holter monitoring or implantation of a remotely activated Reveal device (for those patients with intermittent collapse where longer interrogation periods are required).

Our dedicated, 24-hour nursing care allows close management of cases with chest drains in place, and patients requiring oxygen supplementation. In acute cases with ventilatory failure, we can provide mechanical ventilation supported by our specialist and dedicated anaesthesia team.

Case:
 
Zeus came to AMVS as a 2 year old Yorkshire Terrier with a chronic intermittent cough of 1 year duration, and inspiratory noise triggered by excitement /exercise.

Zeus had a dry honking cough but was otherwise well. Blood tests did not raise any concerns for other diseases.

Videofluoroscopy showed Zeus had a focal dorsoventral narrowing of the intrathoracic trachea at the level of the 3rd-4th rib that varied in size with breathing. The focal narrowing represented a focally exaggerated region of tracheal collapse. There was also evidence of tracheal collapse of the most caudal segment of the thoracic trachea.
 


Zeus had a team of vets with the medicine team performing bronchoscopy with specialist anaesthesia intervention.  This found tracheal collapse in Zeus was severe (grade III- IV) and not only affected the distal part of the intrathoracic trachea but also the left mainstem bronchus.
 


Bronchoalveolar lavage was performed and samples were sent for full analysis, including an infectious respiratory panel which did not find any other evidence of respiratory disease.
Zeus was diagnosed with a collapsing trachea due to weakness of the cartilage supporting the airway.

Zeus was measured for a tracheal stent under strict criteria to ensure the appropriate size stent was selected.
 


Zeus had a tracheal stent placed under fluoroscopic guidance with help from our medicine,  radiology  and anaesthesia teams.
 

 


Zeus has ongoing rechecks to ensure his stent remains  stable and receives daily medication to minimise any residual cough. He lives a very pampered life sharing his home with his family and other dogs. Three years later…he consented to pause for a photo.
 


Extraordinary People
Exceptional Care